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ASCO Offers Guidelines for Treating Adult Cancer Survivors

By Kelly Young

The American Society of Clinical Oncology has released three guidelines on treating problems commonly encountered by adult cancer survivors: chemotherapy-induced peripheral neuropathy, anxiety and depression, and fatigue. The guidelines are published in the Journal of Clinical Oncology.

To treat chemotherapy-induced peripheral neuropathy, clinicians may offer patients duloxetine. The group declined to make official recommendations on tricyclic antidepressants, gabapentin, and a topical gel (comprising baclofen, amitriptyline, and ketamine), but said they may be reasonable options in certain patients.

Patients should be periodically evaluated for depression and anxiety, and compliance with treatments should be assessed regularly. After 8 weeks, if symptoms have not improved, clinicians should try a new approach.

Patients should be screened for fatigue at the time of cancer diagnosis and routinely thereafter, at least annually. They should be educated about ways to manage fatigue, such as through physical activity (150 minutes of moderate aerobic weekly plus two to three strength training sessions), cognitive behavioral therapy, and mindfulness-based approaches like yoga and acupuncture.

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